Prescription Drug Abuse

By Bill Lockwood, Publisher

All of you, I know, are familiar with the prescription-monitoring programs (PMPs) that require pharmacies to report the prescriptions dispensed for controlled substances. This is not limited to pharmacies, however, but includes veterinarians and physicians dispensing such products, as well. Now states are beginning to require that prescribers and dispensers register with the programs to query the repository. In a few states physicians are required, under certain circumstances, to check a person out before writing the prescription. What the prescription-monitoring programs want to see is more use of the data they are collecting. The American Society for Automation in Pharmacy (ASAP) developed a Web Service standard to avoid having to step out of the workflow to access the PMP data. I mentioned this in my last editorial.

Prescription drug abuse is a hot topic these days. I am sure you are aware of the FDA’s recent decision to block generic versions of the original OxyContin. The FDA favors the new version of OxyContin. This formulation contains a polymer that makes the pills harder to crush, break, or dissolve, which is what abusers do to inject or snort the drug for faster results.

Now we have companies jumping in with sophisticated algorithms that can assist physicians in their prescribing decisions for painkillers. The algorithms are targeting abuse with workers’ comp claims, and one purpose is to help prevent addiction to these drugs. It should come as no surprise that insurance companies are behind this approach, in order to reduce their cost. Apparently, what’s being paid out in workers’ comp claims has risen dramatically over the years.

Pharmacies are at the forefront in addressing the abuse issue. The early PMPs wanted to know what was being dispensed by pharmacies. Fortunately, the pharmacy management system could be programmed to automatically send the file of controlled substances for the required reporting frequency. Since then states have worked with ASAP to improve the scope and quality of the data received.

Now we have the National Association of Boards of Pharmacy (NABP) InterConnect program that allows states to share the information reported to them. InterConnect has really taken off, with NABP predicting that it will have 25 states participating come the end of the year. This allows prescribers and pharmacists to not only request information on a person of interest from their state, but can include in the request data from neighboring states to get a more complete picture.
So what’s the take-away here? While abuse of prescription drugs is still not under control, by any stretch of the imagination, the problem is being tackled on a number of fronts as never before. We should start seeing results. CT